Citation:
Costello, Compton, Keeler, & Angold (2003). Relationship between poverty and psychopathology: A natural experiment. JAMA, 15, 2023-2029
Dear Ashley,
Here are the methods:
Child and Adolescent Psychiatric Assessment. The Child and Adolescent Psychiatric Assessment29 is a structured interview for use with both children and parents or guardians that enables interviewers to determine whether symptoms, as defined in an extensive glossary, are present or absent, and to code their frequency, duration, and onset. The Child and Adolescent Psychiatric Assessment scoring algorithms can be used to generate either diagnoses made using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV),30 or scale scores that count the number of DSM-IV psychiatric symptoms relating to any of 29 separate diagnoses or groups of diagnoses. For these analyses, in addition to DSM-IV diagnoses, scale scores were created to cover 2 broad categories of symptoms: those occurring in an emotional disorder (depression or anxiety) and those consistent with a behavioral disorder (conduct disorder or oppositional defiant disorder).
To obtain relatively stable estimates of symptom scores for each child over time, we calculated 3 mean 4-year symptom scores for the period before the casino opened (1993-1996): 1 for all symptoms, and 1 each for behavioral and emotional symptoms separately. Another 3 symptom scores were calculated for the 4-year period after the casino opened (1997-2000). These 6 mean symptom scores served as the primary outcome measure for all analyses. Children also were classified as having 1 or more emotional disorders or behavioral disorders in the period before and after the casino opening. Both types of disorder were entered together into the models to control for comorbidity.31
Classification Variable. The adult respondent (usually the mother) provided information about total family income and sources of income (from earnings, welfare, etc) and rank ordered the sources from the largest to the smallest percentage of total family income. The mean family income for the 4 years before and the 4 years after the casino opened was calculated separately. Families were defined as poor if the mean income for the 4-year period, adjusted for family size and missing data, was below the federal poverty line for that year, using the Department of Health and Human Services guidelines (available at http://www.census.gov/hhes/poverty/threshld.html). Results of repeated analyses using the median were very similar.
Families then were classified into 3 groups: (1) persistently poor, those families below the federal poverty line before and after the casino opened; (2) ex-poor, those families who moved out of poverty after the casino opened; and (3) never poor, those families above the poverty line before and after the casino opened. The fourth possible group, the newly poor (those families who were not poor before the casino opened but became poor later), were excluded from all analyses because of the small number of them (n = 8) among the American Indian families.
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